焦虑状态对糖尿病合并白内障超声乳化术后干眼症状及炎性因子影响

Influence of anxiety on inflammatory factors and dry eye symptom in diabetic patients after phacoemulsification

目的探讨不同焦虑状态对糖尿病合并白内障超声乳化术后干眼症状及炎性因子的影响。方法选择糖尿病合并白内障患者76例(96眼),采用汉密尔顿焦虑量表(HAMA)分为焦虑组及非焦虑组,每组分别有50眼、46眼。入选后分别行干眼主观症状评分、泪膜破裂时间(BUT)测定、基础泪液分泌实验(SIt)、角膜荧光素染色(FL)及炎性因子检测。结果焦虑组及非焦虑组治疗后1 w后较治疗1 d干眼症状均有改善(P<0.05),焦虑组较非焦虑组治疗1 w后差异有统计学意义(P<0.05)。焦虑组及非焦虑组治疗后1 w后BUT、Sit、FL较治疗1 d差异有统计学意义(P<0.05),2组治疗1 w后BUT、Sit、FL差异有统计学意义(P<0.05)。焦虑组及非焦虑组治疗后1 w后IL-1β、IL-6、TNF-α较治疗1 d差异有统计学意义(P<0.05),焦虑组较非焦虑组治疗后1d IL-6、TNF-α差异有统计学意义(P<0.05);2组治疗1 w后IL-1β、IL-6、TNF-α差异均有统计学意义(P<0.05)。结论焦虑状态可影响糖尿病合并白内障超声乳化术后干眼症状,这可能与炎性因子失调有关。

Objective To investigate influence of anxiety on inflammatory factors and dry eye symptom in diabetic patients after phacoemulsification. Methods 76 patients with diabetic cataract （96 eyes） were enrolled. According to Hamilton Anxiety Scale （HA- MA） ,the patients were divided into anxiety groups and non -anxiety groups ,which were 50 eyes and 46 eyes separately. Dry eye subjective symptom scores, tear film breakup time （BUT） measurement, Schirmer test （Sit）, corneal fluorescein staining （FL） and inflammatory fac- tors test were conducted. Results Anxiety and non - anxiety group after treatment for lw showed significant improvement compared with treatment for one day （P 〈 0.05）. Anxiety group were significantly higher than that in non - anxiety group （ P 〈 0.05） after treatment for lw. Compared with the treatment one day,BUT,Sit and FL after treatment at lw had a significant improvement in anxiety and non -anxiety group （P 〈 0.05）. At 1d, Sit and FL in anxiety group and the non- anxiety group showed significantly difference （P 〈 0.05 ）, and after treatment for one week,BUT,Sit and FL were significant differences （P 〈0.05）. Treatment lw compared to one day ,IL -1β,IL -6,TNF - α have a significant improvement （P 〈 0.05 ） in anxiety group and non - anxiety group. Compared with baseline, IL - 6, TNF - α after one day treatment showed significant difference （P 〈 0.05） in non - anxiety anxiety group non - anxiety group. Conclusion Anxiety can affect dry eye symptoms in diabetic patients after phacoemulsification,which may be due to inflammatory factors disorder.